Application of the Caprini Risk Assessment Model for Evaluating Postoperative Deep Vein Thrombosis in Patients Undergoing Plastic and Reconstructive Surgery.


Journal

Annals of vascular surgery
ISSN: 1615-5947
Titre abrégé: Ann Vasc Surg
Pays: Netherlands
ID NLM: 8703941

Informations de publication

Date de publication:
May 2020
Historique:
received: 22 03 2018
revised: 02 09 2019
accepted: 22 10 2019
pubmed: 5 11 2019
medline: 15 9 2020
entrez: 4 11 2019
Statut: ppublish

Résumé

The optimal approach for assessing the risk of venous thromboembolism (VTE) in patients undergoing plastic surgery is yet to be established. This study aimed to determine the validity of the Caprini Risk Assessment Scale in identifying patients undergoing plastic surgery who are at a high risk of developing VTE. Between December 2014 and November 2015, we enrolled 90 patients. Risk factors for VTE were assessed at baseline. The Caprini Risk Assessment Model was used to stratify patients into Caprini <4, Caprini 5-6, Caprini 7-8, and Caprini >8 groups before examination. We preoperatively screened for deep vein thrombosis (DVT) using duplex ultrasound. During operation, surgical duration and blood loss were recorded. Duplex ultrasound was repeated 2 and 7 days postoperatively to evaluate for DVT. We used a univariate analysis to determine risk factors for postoperative VTE. Confounding predictors were finally tested using a multivariate logistic regression analysis. One patient had preoperative DVT and was excluded from the study. Eighty-nine patients were included in the final analyses. Of the 89 patients, 7 (8%) developed postoperative DVT. Mean age, body mass index, Caprini score, and surgical duration were significantly higher in patients who developed postoperative DVT. Variables associated with increased risk of postoperative DVT using univariate analysis were Caprini scores of 7-8 and >8. Multivariate logistic regression analysis finally identified Caprini scores 7-8 [odds ratio (OR) 13, 95% confidence interval (CI) 1.67-101.98, P = 0.014] and >8 (OR 19.5, 95% CI 1.02-371.96, P = 0.048) to be independently associated with postoperative DVT. Although the incidence of postoperative DVT is relatively low among patients undergoing plastic surgery, Caprini scores can be used to predict postoperative VTE complications.

Sections du résumé

BACKGROUND BACKGROUND
The optimal approach for assessing the risk of venous thromboembolism (VTE) in patients undergoing plastic surgery is yet to be established. This study aimed to determine the validity of the Caprini Risk Assessment Scale in identifying patients undergoing plastic surgery who are at a high risk of developing VTE.
METHODS METHODS
Between December 2014 and November 2015, we enrolled 90 patients. Risk factors for VTE were assessed at baseline. The Caprini Risk Assessment Model was used to stratify patients into Caprini <4, Caprini 5-6, Caprini 7-8, and Caprini >8 groups before examination. We preoperatively screened for deep vein thrombosis (DVT) using duplex ultrasound. During operation, surgical duration and blood loss were recorded. Duplex ultrasound was repeated 2 and 7 days postoperatively to evaluate for DVT. We used a univariate analysis to determine risk factors for postoperative VTE. Confounding predictors were finally tested using a multivariate logistic regression analysis.
RESULTS RESULTS
One patient had preoperative DVT and was excluded from the study. Eighty-nine patients were included in the final analyses. Of the 89 patients, 7 (8%) developed postoperative DVT. Mean age, body mass index, Caprini score, and surgical duration were significantly higher in patients who developed postoperative DVT. Variables associated with increased risk of postoperative DVT using univariate analysis were Caprini scores of 7-8 and >8. Multivariate logistic regression analysis finally identified Caprini scores 7-8 [odds ratio (OR) 13, 95% confidence interval (CI) 1.67-101.98, P = 0.014] and >8 (OR 19.5, 95% CI 1.02-371.96, P = 0.048) to be independently associated with postoperative DVT.
CONCLUSIONS CONCLUSIONS
Although the incidence of postoperative DVT is relatively low among patients undergoing plastic surgery, Caprini scores can be used to predict postoperative VTE complications.

Identifiants

pubmed: 31678541
pii: S0890-5096(19)30937-9
doi: 10.1016/j.avsg.2019.10.082
pii:
doi:

Types de publication

Journal Article Validation Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

82-89

Informations de copyright

Copyright © 2019 Elsevier Inc. All rights reserved.

Auteurs

Hiroki Yago (H)

Department of Plastic and Reconstructive Surgery, Tokyo Women's Medical University, Tokyo, Japan. Electronic address: yago.hiroki@gmail.com.

Takashi Yamaki (T)

Department of Plastic and Reconstructive Surgery, Tokyo Women's Medical University, Tokyo, Japan.

Yumiko Sasaki (Y)

Department of Plastic and Reconstructive Surgery, Tokyo Women's Medical University, Tokyo, Japan.

Kento Homma (K)

Department of Plastic and Reconstructive Surgery, Tokyo Women's Medical University, Tokyo, Japan.

Takatoshi Mizobuchi (T)

Department of Plastic and Reconstructive Surgery, Tokyo Women's Medical University, Tokyo, Japan.

Yuki Hasegawa (Y)

Department of Plastic and Reconstructive Surgery, Tokyo Women's Medical University, Tokyo, Japan.

Atsuyoshi Osada (A)

Department of Plastic and Reconstructive Surgery, Tokyo Women's Medical University, Tokyo, Japan.

Hiroyuki Sakurai (H)

Department of Plastic and Reconstructive Surgery, Tokyo Women's Medical University, Tokyo, Japan.

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